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Launching a coalition is an exciting step toward advancing meaningful policy change—but the real work begins once the group comes together. Coalitions require more than shared goals; they demand structure, coordination, and compromise. To be effective, coalition members must align on principles, stay organized, and understand how to best support one another’s strengths. This post explores the essential elements of building and managing a successful policy coalition—from setting ground rules to driving actionable outcomes.
Building and Managing a Successful Policy Coalition
Forming a coalition is a powerful way to advance a policy agenda—but success depends on how well the coalition is organized, aligned, and activated. From setting shared principles to leveraging individual strengths, a well-run coalition can be greater than the sum of its parts. Below are key strategies for building and managing an effective coalition.
Establish Policy Agreement and Ground Rules
The foundation of any successful coalition is mutual agreement on core policy principles. At the outset, it is essential that all members buy into a simple but important tenet: you must give a little to get a lot. Coalitions often falter when partners overreach or become too rigid in their demands. Instead, focus on defining key policy goals and the parameters the group will work within. Building consensus early on helps avoid unnecessary conflict later and ensures the group can speak with one voice.
Prioritize Strong Administration
Good ideas will not go far without strong organization. Set a consistent cadence for meetings—whether weekly, biweekly, or monthly—to maintain momentum. Make sure to capture and distribute meeting notes to help refresh ideas, keep members accountable, and track progress over time. This structure allows members to stay focused and productive between meetings and ensures the group continues to move forward.
Leverage the Strengths of Your Partners
Each coalition partner brings something unique to the table. One group might have expertise in policy analysis and drafting, while another excels at grassroots organizing, digital advocacy, or legislative outreach. Understanding your partners’ strengths allows you to delegate effectively and play to each member’s comparative advantage. This not only builds trust but also maximizes the coalition’s collective impact.
Define Action Items and Next Steps Clearly
Before each meeting, have a clear idea of what outcomes you’re aiming to achieve. If you’re hoping for agreement on a particular action item, guide the discussion strategically toward that goal. Anticipate possible objections and be prepared to adjust the conversation without losing sight of your objective. At the end of each meeting, assign responsibilities and clarify next steps to keep the coalition on track and moving toward its shared policy goals.
Chamber Hill Strategies
When it comes to coalition building, Chamber Hill Strategies stands out among lobbying firms in DC. Our comprehensive approach helps clients achieve their advocacy goals. With strong relationships on Capitol Hill and a track record of shaping health policy, we turn complex challenges into real-world wins.
Let our expertise in Washington, DC guide your efforts towards successful and meaningful stakeholder engagement. Look for our next blog about successfully identifying the right partners.
On May 20, 2025, the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies held a hearing on the FY26 budget request for the Department of Health and Human Services (HHS). Much like Sec. Kennedy’s appearances before the House Labor-HHS and Senate Health, Education, Labor, and Pensions Committees on May 14, members asked questions about the proposed HHS reorganization, Medicaid, and rural health care. Also, like in the prior hearings, many Republican members praised Kennedy’s “Make America Health Again” (MAHA) agenda. Democrats criticized Sec. Kennedy for reducing HHS’s workforce, expressed concerns about proposed funding cuts in FY 26, and argued that Republicans were trying to cut Medicaid benefits under the reconciliation bill.
OPENING STATEMENTS
WITNESS TESTIMONY
MEMBER DISCUSSION
HHS Reorganization and Withholding Funds
As was the case with previous hearings on the FY 26 budget request, much of the focus was on HHS’s reorganization and concerns about the withholding of funds. Appropriations Committee Chair Susan Collins (R-ME) asked about the impact of the reorganization on funding for the Centers for Disease Control and Prevention’s (CDC) brain injury program. Sec. Kennedy explained that his attorneys instructed him not to comment on that matter due to ongoing legal action against the administration’s actions. Subcommittee Chair Shelly Moore Capito (R-WV) asked about the impact of the reorganization on clinical trials. Sec. Kennedy assured her that the trials were not being cut. Subcommittee Ranking Member Tammy Baldwin (D-WI) expressed concerns about specific HHS funding that had been appropriated but not yet distributed. Sen. John Kennedy (R-LA) defended the reorganization by pointing out that large companies, such as Microsoft and Meta, have continued to function after undergoing restructuring and layoffs.
FY 26 HHS Budget Request Details
Subcommittee Ranking Member Baldwin and Sen. Patty Murray (D-WA) pressed for more specifics about the President’s FY 26 HHS budget request. Specifically, Ranking Member Baldwin asked when she could expect a detailed plan for the 530 programs that currently lack designated funding amounts in the proposed budget. Sec. Kennedy replied that those decisions are being made by the Office of Management and Budget (OMB) and framed the issue as a government-wide matter rather than an HHS-specific one. Ranking Member Baldwin also raised alarm over withheld funds to the National Institutes of Health (NIH) research, particularly in immunotherapy, citing a $3 billion drop in awarded funding and a decrease in grants. She asked who was responsible for holding the grants. Sec. Kennedy responded by saying that gene therapy is a priority. When Sen. Baldwin asked if the Department of Government Efficiency (DOGE) was reviewing the cuts, he reiterated a focus on cutting waste and fraud. Sen. Patty Murray (D-WA) questioned whether HHS was required to submit an operating plan outlining how every program would be run, including funding levels. She requested a comprehensive version, citing the need to understand which programs would be cut and how taxpayer dollars were being allocated.
Medicaid
Sens. Jack Reed (D-RI) and Jeff Merkley (D-OR) raised concerns about proposed Medicaid changes in the reconciliation legislation, stating that the proposed changes would lead to millions of people losing health coverage. These Senators inquired about the rationale behind these cuts. Sec. Kennedy responded with the same arguments he made last week that the reductions were not outright cuts but rather decreases in the rate of program growth. He emphasized that the changes were intended to eliminate waste, fraud, and abuse, claiming that people are stealing from the Medicaid program. He further argued that able-bodied men who refuse to work are contributing to the strain on the program.
Rural Health Care
Subcommittee Chair Capito raised concerns about how the administration’s proposed budget cuts could impact rural health care programs, asking Sec. Kennedy how his reorganization plan would improve conditions in rural America. Kennedy acknowledged that rural health is one of the most frequently raised issues. He noted that many rural hospitals are closing and emphasized their importance as economic drivers in their communities. He mentioned ongoing discussions with leading health technology companies to help address the issue.
Sen. John Boozman (R-AR) highlighted that cancer remains a leading cause of death and pointed out the lack of designated cancer centers in rural areas. He asked how HHS could improve patient outcomes and better support rural regions. Kennedy agreed that access to cancer treatments is necessary and acknowledged the challenges. Sen. Boozman further emphasized that rural counties face serious barriers, with many providers struggling to keep their doors open. He referenced the upcoming Farm bill and asked how to help build strong health infrastructure in those communities. Sec. Kennedy pointed to several programs under the Health Resources and Services Administration (HRSA), including the 340B drug pricing program. He recognized its significance to hospitals and rural health efforts and added that a revolution in AI could bring significant advancements. This is the second time that Sec. Kennedy has expressed his understanding that the 340B program is important to rural hospitals.
Sen. Brian Schatz (D-HI) brought attention to the fact that rural Americans are less likely to receive preventive health care. He questioned whether the administration’s stance on Diversity, Equity, and Inclusion (DEI) would limit the ability to understand how different populations respond to different types of care. Kennedy replied that this was not a DEI issue, citing he is working with Sen. Tim Scott (R-SC) on the delivery of a new sickle cell treatment to all who suffer from the disease in South Carolina as an example of an effort to ensure equitable care.
OTHER TOPICS
- Sen. Jerry Moran (R-KS) raised concerns about the measles outbreak in Kansas and the need for support for individuals with mental health disabilities. He also expressed his support for the BOLD Act.
- Sen. Jeanne Shaheen (D-NH) asked for a commitment to preserving the state opioid grant program, emphasizing its importance. She was assured it remains a priority, though past efforts to address the opioid crisis were acknowledged as insufficient.
- Committee Chair Collins asked if there would be support to restore the Leadership Education in Adolescent Health (LEAH) program and aid for low-income families.
- Sen. Kennedy questioned why processed foods were allowed to be sold in America. Sec. Kennedy responded that the food industry profits on poisoning children.
Over the past two weeks, Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. testified before several Congressional committees regarding the FY26 HHS budget request, including the Senate Appropriations Subcommittee on Labor-HHS, the House Appropriations Subcommittee on Labor-HHS, and the Senate Committee on Health, Education, Labor, and Pensions (HELP). These hearings covered a wide range of topics, including HHS reorganization, Medicaid changes, vaccine policies, chronic disease, rural health, research funding, and the broader Make America Healthy Again (MAHA) agenda. The hearings marked the first round of Congressional review of the FY26 request.
Budget Request Priorities and Testimony Highlights
In his testimony, Sec. Kennedy highlighted the administration’s focus on reducing chronic disease and increasing operational efficiency. The FY26 budget proposal includes:
- Consolidating mental health programs to better address rising rates of mental illness and substance use.
- Prioritizing nutrition, physical activity, and exercise, with $94 billion requested for the Administration for a Healthy America (AHA).
- Expanding FDA food safety efforts.
- Cutting research deemed redundant, dangerous, or overly focused on DEI metrics.
- Leveraging AI and other technologies to improve health data management and service delivery.
- Restoring public trust in federal health agencies.
HHS Reorganization and Withholding Funds
The reorganization of HHS drew criticism from Democrats. Democrats, including Sen. Tammy Baldwin (D-WI) and Rep. Rosa DeLauro (D-CT), raised alarms about funds appropriated by Congress being withheld, particularly for NIH immunotherapy research. Sec. Kennedy defended the actions as part of a larger effort to cut waste and emphasized OMB’s role in making final funding decisions. He stated that while legal action prevents him from commenting on specifics like the CDC brain injury program, all actions are intended to increase agency efficiency. Sen. Susan Collins (R-ME) and others expressed concern about funding uncertainty impacting key health initiatives.
HHS Workforce Reductions
Reductions in the HHS workforce were another flashpoint. Sec. Kennedy stated that he and his staff made the final decisions, though Elon Musk offered informal guidance. Rep. Steny Hoyer (D-MD) and Sen. Tim Kaine (D-VA) pressed for clarity on the decision-making process, while Democrats questioned whether Congress had been consulted. Republicans largely defended the cuts as part of broader government reform efforts.
Medicaid
Democratic lawmakers criticized the proposed Medicaid reforms included in the reconciliation bill, arguing the changes would significantly reduce coverage for vulnerable populations. Sec. Kennedy, joined by Republicans like Rep. Andy Harris (R-MD), countered that the reforms would reduce fraud, eliminate waste, and target coverage toward eligible recipients. Provisions such as work requirements for non-disabled adults and limits on care for undocumented immigrants were especially contentious.
Chronic Disease
Members across party lines acknowledged the importance of addressing chronic disease. While Republicans praised Kennedy’s Make America Health Again (MAHA) initiative, Democrats objected to cuts at Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of Minority Health. Sec. Kennedy characterized the changes as a realignment, not a reduction. Sen. Jon Husted (R-OH) expressed enthusiasm for MAHA’s direction, and Sen. Tim Scott (R-SC) advocated banning artificial dyes in foods.
Rural Health
Rural health care emerged as a significant theme. Lawmakers highlighted hospital closures and provider shortages. Sec. Kennedy pointed to partnerships with health tech firms and AI applications as potential solutions. He cited support for Health Resources Services and Administration (HRSA) programs like 340B and mentioned efforts to improve access to cancer treatments and preventive care. Sen. Brian Schatz (D-HI) raised equity concerns regarding DEI rollbacks, which Kennedy dismissed, citing bipartisan efforts to ensure equitable access, such as sickle cell treatment expansion in South Carolina.
Vaccines
Amid a growing measles outbreak, Democratic lawmakers pressed Kennedy on his stance on vaccines. Although Kennedy acknowledged public mistrust and concerns, he ultimately affirmed that the measles vaccine is the most effective means of prevention. He emphasized that his recommendations are based on multiple sources.
Other Topics
- Sen. Moran (R-KS) expressed support for the BOLD Act.
- Sen. Jeanne Shaheen (D-NH) expressed support for opioid crisis grants and Sec. Kennedy agreed.
- Sen. Collins discussed restoring the LEAH program and boosting aid for low-income families.
- Reps. Clyde (R-SC), Ellzey (R-TX), and DeLauro (D-CT) raised concerns over unaccompanied minors and family separation accountability.
- Members from both parties emphasized the need to reduce dependency on Chinese pharmaceutical supply chains.
- Sen. Cassidy (R-LA) voiced concerns about the closure of the Office of Long COVID Research.
- Sen. Josh Hawley (R-MO) is reportedly drafting legislation to limit pharmaceutical advertising.
The reauthorization of the Dr. Lorna Breen Health Care Provider Protection Act marks an ongoing effort to support the mental health of health care professionals. This bipartisan legislation not only continues the legacy of Dr. Lorna Breen but also reflects the importance of a robust mental health infrastructure for those on the front lines of medical care.
The Dr. Lorna Breen Health Care Provider Protection Act is up for reauthorization. A bipartisan bill in Congress demonstrates ongoing support for the mental health of health care professionals. What’s the latest on this legislation?
Dr. Lorna Breen
Dr. Lorna Breen was an emergency physician and medical director at New York-Presbyterian Allen Hospital in Manhattan. She was known for her dedication during the early days of the COVID-19 pandemic, which took a severe toll on her mental health. After her death by suicide in April 2020, her family founded the Dr. Lorna Breen Heroes Foundation to improve mental health support for health care workers.
The Dr. Lorna Breen Health Care Provider Protection Act was enacted in 2022 to help break down the stigma that often prevents medical professionals from seeking help. The bill established a new standard for embedding mental health into health care practices, reinforcing the idea that provider well-being is vital to delivering quality patient care.
Key Provisions of the Reauthorization
The reauthorization would extend critical programs from 2026-2030, focusing on:
- Grant Programs: Continued funding for health care organizations and professional associations to implement strategies that reduce burnout, provide peer support, and offer mental health treatment.
- Educational Initiatives: Support for health profession schools to train students and professionals in preventing suicide, burnout, and substance use disorders.
- Awareness Campaigns: Expansion of national campaigns to educate health care leaders on evidence-based solutions to mitigate provider burnout and promote well-being.
This extended funding at $45 million annually, totaling $225 million over five years prioritizes communities with health care worker shortages, rural areas, and those experiencing high levels of burnout due to administrative burdens.
Bicameral Support Reflects National Consensus
The act’s reauthorization has garnered support from both sides of the political aisle, demonstrating a strong commitment to address the mental health crisis among health care workers. Senators Tim Kaine (D-VA), Jack Reed (D-RI), Roger Marshall (R-KS) and Todd Young (R-IN), along with Representatives Debbie Dingell (D-MI-06), Jen Kiggans (R-VA-02), Jennifer McClellan (D-VA-04) and Miller-Meeks (R-IA-01), have been instrumental in championing this cause.
Outlook for the Breen Act
Corey Feist, CEO of the Dr. Lorna Breen Heroes Foundation, has been making the rounds in Congress advocating for the bill’s reauthorization. Despite bipartisan support, there is no clear path yet for the legislation.
Congressional Democrats remain frustrated that the measure wasn’t renewed in December 2024, blaming its failure in part on social media posts by Elon Musk that were later backed by Donald Trump. Musk tweeted that the health care package, which included this bill, should not pass Congress.
Partisanship again is prevailing in Congress over budget legislation to reduce Medicaid spending and extend tax cuts. The Chair of the House Energy and Commerce Health Subcommittee, Rep. Buddy Carter (R-GA-01), remains supportive but has deferred action on the measure so far. When the subcommittee unanimously advanced the measure in March 2024, Carter called it a “landmark” law and a “lifeline for health workers.” While acknowledging that Congress is currently focused on other priorities, he recently expressed confidence that the Breen Act will ultimately be renewed, saying, “It will be alright.”
Looking Ahead
The timing of reauthorizing the Breen Act is uncertain, but the urgency of addressing health care worker burnout remains. As Congress wrestles with competing priorities, this legislation serves as a reminder that providers’ mental well-being must not be overlooked.